Jessica Marie Kotsakis

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

620 S 76TH St
Milwaukee, WI 53214-1599

Phone

(414) 453-1400

Fax

(414) 453-2538

NPI assigned

Jul 26, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1871266072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1885 LONE OAK CIR W",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530455017",
            "telephone_number": "262-894-0742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 S 76TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532141599",
            "telephone_number": "414-453-1400",
            "fax_number": "414-453-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTSAKIS",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871266072",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jkotsakis@chw.org",
            "affiliation": "Y",
            "endpointDescription": "Email",
            "affiliationName": "Children's Hospital of Wisconsin",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8915 W Connell Ave",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532263067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Diane Colette Kothera, RDH
• Hanumantha R. Kothur, M.D.
• Biana Kotlyar, M.D.
• Fabiana Kotovicz, MD
• Chloe Reese Kotrba
• Thomas Christopher Kotsonis, M.D.
• Yuriy Kotsurovskyy, MD, MSC
• Bryan Koudim, PTA
• Hayden Grace Koukios, AU.D
• Dani-Joy Kovac, CNM

• Clinical Social Worker in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.